Provider Demographics
NPI:1932694262
Name:GADWAL, THANVEER REDDY (PHARMD)
Entity Type:Individual
Prefix:
First Name:THANVEER
Middle Name:REDDY
Last Name:GADWAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9615 SHERRILL ESTATES RD STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6552
Mailing Address - Country:US
Mailing Address - Phone:980-441-8600
Mailing Address - Fax:980-441-8625
Practice Address - Street 1:9615 SHERRILL ESTATES RD STE B
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:980-441-8600
Practice Address - Fax:980-441-8625
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist